Clinical and sonographic features of the pancreatic steatosis in children with overweight and obesity
Journal Title: Гастроентерологія - Year 2017, Vol 51, Issue 4
Abstract
Background. Early diagnosis of pancreatic steatosis is essential for the early metabolic risk detection and chronic gastroenterological morbidity reduction. The purpose was to examine the clinical and sonographic features of pancreatic steatosis in children with overweight and obesity. Materials and methods. The presence of pancreatic steatosis was determined by ultrasonography in 53 children with functional disorders of the gastrointestinal tract. Division in groups was performed on the basis of pancreatic steatosis and obesity/overweight presence: group 1 consisted of 24 patients with pancreatic steatosis and obesity/overweight, group 2 included 18 children with obesity/overweight with no signs of pancreatic steatosis, the control group consisted of 11 patients without pancreatic steatosis and with normal weight. Results. The clinical picture in children with pancreatic steatosis may be explained by concomitant gastroenterological diseases, but 29.1 % of group 1 patients complained of pain in the left upper quadrant. Patients with steatosis often complained of nausea (58.3 %), flatulence (45.8 %) in comparison to patients who had normal weight, but the significance of the differences was not sufficient. Group 1 patients often reported pain on palpation of the intestine compared with other 2 groups. Pain on palpation in pancreatic points was significantly higher in group 1 patients (54.1 %) compared to group 3. Increased liver echogenicity was found 2.4 times more often in group 1 patients compared with group 2. In particular, changes in liver grains were three times more common in patients with steatosis (p < 0.05), as compared to the obese patients without steatosis and to the children with normal weight. Pancreatic changes in steatosis manifested not only by the changes in echogenicity, but also by fuzzy contours of the pancreas, increased grain (65.5 %) in almost half of patients (45.8 %). Gallbladder volume and wall thickness were significantly higher in the group of children with steatosis compared to the control group. Symptoms of biliary sludge were twice more common in children with steatosis compared to children without steatosis and 4 times more likely than in children with normal weight (43.87 % in group 1; 21 % in group 2, and 9 % in group 3). Conclusions. Thus, clinical and sonographic features in patients with steatosis indicate the possibility of inflammatory changes in the parenchyma associated with systemic inflammation due to steatosis and concomitant diseases of the gastrointestinal tract.
Authors and Affiliations
Yu. M. Stepanov, N. Yu. Zavgorodnya, O. Yu. Lukianenko
Effect of Genetic Polymorphism on the Formation of Nonalcoholic Fatty Liver Disease
The article deals with the results showing the existence of the preconditions for the formation of non-alcoholic fatty liver disease (NAFLD) in patients with metabolic disorders. This is due to reliable association of al...
Functional Dyspepsia in the Light of the Rome IV Criteria
The article deals with the problem of functional dyspepsia. The pathophysiology is described in detail, the diagnostic criteria of this disease are given, the aspects of treating patients with functional dyspepsia are co...
Effect of Nutritional Status Disorders on the Quality of Life in Patients with Chronic Inflammatory Bowel Diseases
The article deals with the actual problem — the influence of nutritional status on the quality of life in patients with chronic inflammatory bowel diseases. A survey of 80 patients was conducted using general (SF‑36) an...
Management of Patients with Gastroesophageal Reflux Disease in the Light of the Recent American Consensus
The paper gives a review of a new consensus on the diagnosis and management of patients with gastroesophageal reflux disease (GERD), developed by the American College of Gastroenterology, discusses how the approaches rec...
Psychological Dysadaptation in Patients with Gastroesophageal Reflux Disease: Review and Own Researches
The article presents up-to-date data concerning psychosomatic problem in medicine, in particular world experience of studying disorders of psychological of adaptation in patients with gastroesophageal reflux disease (GER...